title: In situ kidney insonation with microbubble contrast agents does not cause renal tissue damage in a porcine model.
abstract: OBJECTIVE
  Knowledge and quantification of the microcirculation are very important for estimating the status of an organ. Real-time contrast-enhanced sonography assesses microvascular tissue perfusion. This technique has been proposed as innocuous; however, data from experimental animals (rats) have shown renal interstitial microhemorrhage after the procedure. Therefore, we developed a porcine model to explore potential renal damage that in situ exposure might cause.
  
  
  METHODS
  Kidneys from 8 anesthetized pigs were surgically exposed. An ultrasound contrast agent (sulfur hexafluoride) was infused through the femoral vein in a continuous perfusion. Destructive ultrasonic flashes were applied with a high mechanical index over only 1 kidney (the contralateral kidney was used as a control). Blinded histologic and laboratory analyses were performed to reveal any lesions.
  
  
  RESULTS
  Histologic analysis of the kidney samples showed no evidence of renal damage. Biochemical parameters that could represent renal tissue damage and hemoglobin levels did not change after the microbubble-ultrasound interaction.
  
  
  CONCLUSIONS
  The ultrasound contrast agent-ultrasound interaction in anesthetized pig kidneys under the output level for the imaging visualization and microbubble destruction used did not cause tissue damage. Our results suggest that this procedure could be used in humans for regular analysis of the kidney microcirculation with minimal risk of tissue damage.
authors.affiliation: Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain. cjimenezm.hulp@salud.madrid.org
authors.forename: Carlos
authors.initials: C
authors.lastname: Jiménez
authors.forename: Raquel
authors.initials: R
authors.lastname: de Gracia
authors.forename: Alfredo
authors.initials: A
authors.lastname: Aguilera
authors.forename: Sergio
authors.initials: S
authors.lastname: Alonso
authors.forename: Antonio
authors.initials: A
authors.lastname: Cirugeda
authors.forename: Javier
authors.initials: J
authors.lastname: Benito
authors.forename: Rita María
authors.initials: RM
authors.lastname: Regojo
authors.forename: Río
authors.initials: R
authors.lastname: Aguilar
authors.forename: Andrea
authors.initials: A
authors.lastname: Warlters
authors.forename: Rosa
authors.initials: R
authors.lastname: Gómez
authors.forename: Carlota
authors.initials: C
authors.lastname: Largo
authors.forename: Rafael
authors.initials: R
authors.lastname: Selgas
mesh_terms: D000818:Animals; D003287:Contrast Media; D006801:Humans; D007668:Kidney / Q000166:cytology* / Q000000981:diagnostic imaging* / Q000293:injuries; D045423:Microbubbles; D023421:Models, Animal; D018570:Risk Assessment / Q000379:methods; D013010:Sonication; D013459:Sulfur Hexafluoride / Q000009:adverse effects; D013552:Swine; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D013459:Sulfur Hexafluoride